The hydrokinetic is now a true rehabilitative practice that bases its origins on rediscovery of the healing properties of water through techniques and exercises for each form of pathology and orthopedic and neurological ..
rehabilitation in practice today, many children with disabilities are always encouraged by the team responsible for therapeutic or doctors to attend to enjoy the pools undeniable therapeutic opportunities offered by the physical activities carried out in water. Unfortunately, even today in the pools merge the professionals and the activities to be performed; young patients perform exercises or start training inadequate and often harmful not being followed by appropriately trained staff. You have to know what to do "water gym" is not means doing rehab in the water. Exercise in the healthy subject is the work of sports instructors but rehabilitation must be performed by professionals appropriately prepared, their particular training allows you to use the water in the medical and scientific way and to work through the application of appropriate protocols rehabilitation. The undersigned
Sandro Sollazzo, who graduated from ISEF 1985, teaches physical education at the Salesian Institute "Villa Sora" in Frascati and works as a swimming instructor at the Sports Center Sporting Club Tuscolano. He also graduated in the therapist Neuropsychomotor ETA ' Evolutionary in 2002 with a specialization course: "Motor activities in water for rehabilitation" of the National Association hydrokinesitherapy. Since then follows a number of patients with developmental disabilities in rehabilitation programs in water for orthopedic or neurological. The undersigned has also launched a service from January 2003 hydrokinesitherapy at the Centre for child rehabilitation agreement "Project Man" in Latin America and plans to propose a service Hydrokinesitherapy at your facility.
the undersigned will implement activities in accordance with the hydrokinetic technology (ASP Propedeutico sequential approach), the only completely Italian, which provides:
· The taking over of patients since its entrance into the pool. • The
its transport in water taken to the appropriate assistance.
The treatment using therapeutic protocols for every disease and orthopedic, neurologic, or trauma. The hydrokinetic
outcomes for children with brain injury is a form of supportive therapy that supports and is part of a broader treatment plan that necessarily involves other forms of therapy. The child and his family will certainly be in contact with other professionals and caregivers, so the task of the therapist in the water will be to fit into the teamwork and design his speech along with other figures present.
Children with disabilities often present with clinical complications and harms associated with both visual and auditory sensory system. Obviously the motor impairment is the most obvious and manifested primarily by clinical diparesi of spastic, non-ambulatory spastic quadriplegia, dystonia, and ataxia. There are two main symptoms: pain and stiffness. Water is for these young patients an ideal medium to work with, due to partial absence of gravity allows them to perform movements and exercises that would be impossible and difficult to carry out and allows the therapist to evaluate effectively the residual of these patients. Can we therefore say that water is an essential facilitator for the patient and the therapist.
pain and stiffness are aggravated by anxiety were accumulated by the latent and unconscious brain-injured children and the physical and emotional stress as a result. In fact, their daily and arduous struggle against the force of gravity, the fear of being touched and the fear of falling are factors that lead these children to an attitude of "closure" of their area of \u200b\u200baction, all this is obvious if you look their facial expressions typically suffering. Once immersed in water with all the precautions and appropriate aids and assisted by the therapist through taken appropriate, our children will feel free from gravity. Being protected from the element fluid that surrounds them completely and that supports them, they lose their fear of getting hurt, so even psychologically are more calm and relaxed. Patients experiencing water in a general sense of relaxation and well-being for the stimulation of cutaneous mechanoreceptors which are strong inhibitors of pain and excitement of the parasympathetic system. Because of this natural massage my relaxed-fit that is applied at room temperature (28 ° - 35 ° Celsius), and decreased muscle tone in antigravity muscles relax overuse. The brain-injured children, never having had an "image", an experienced motor correctly received by the practice dell'idrokinesiterapia, if possible, different stimuli and targets according to their clinical status. In individuals who are already compromised in postural because of the results of brain injury, movement in water induces significant therapeutic benefits for their ailments most often: the neurogenic scoliosis, the Cifo-lordosis, pain syndromes of the arm and shoulder, and contractures muscle spasms. The water resistance can be used to re-harmonize the uncoordinated movement patterns. The brain-injured children have to "enable" rather than "rehabilitate" the execution of complex motor patterns, slowing the water's resistance movements, thereby increasing the execution time facilitates this learning. The prerogatives of the positive movement in water are based on certain physical principles: the reduction of the force of gravity, buoyancy through the change in lung volume (breath training) and using the devices, the force of resistance of the medium and finally the change execution speed of movement. The most common targets of treatment in water are to achieve a relaxed state, the control of respiration rate, a new body awareness (body schema) in relation to a new environment. But these objectives can be diversified so as to encourage the creation of individualized rehabilitation projects and more targeted to the clinical picture of each child. Spastic quadriplegia and diparesi
In the more specific objectives are:
· Reduce spasticity by decreasing or preventing the onset of contractions and retractions only possible thanks to the movements in the water and relaxation exercises of the antigravity muscles in the absence of gravity.
Improve the coordination of the respiratory rhythm through exercises and controlled apnea for the reinforcement of the diaphragm and intercostal muscles.
· Contrast alterations of body image and prevent the "neglect" with exercises that foster reintegration body parts using the microgravity and facilitating the mobilization and motor learning.
· Contrast the possible centripetal component (pathological pattern) by environment microgravitario and increase the functionality of the limbs most affected by exercise and floating aids.
Improve the knowledge of his body.
· acquire a mastery of body movements in a liquid space (three dimensional).
· verticality not a risky experiment, social, promoting knowledge of space in front of him, the interaction with objects and people.
· Reduce stress treatment, proposing a little sanitation and rehabilitation activities in a fun environment, swimming pool, which also has recreational aspects. In clinical
where there are also components of the motor ataxic more specific objectives are:
Improve balance and coordination of movements in space using the liquid resistance and the options open water through exercises that allow a partial load on the limbs lower and exercises control during the flotation.
Improve the fine motor skills and manipulation of objects stereognosic evoking knowledge.
· evoke proprioceptive control components through exercises that teach changes in lung volumes and in a kind of biofeedback, facilitating the monitoring and awareness of the subsequent reactions in the flotation.
"Enable" to the use of certain movements and functions that take advantage of facilitating the partial absence of gravity at different levels of water is the slowing of movements.
The objectives will be achieved then checked out of the water and modulated therapies carried out in practice, because as we have repeatedly stated it is necessary to complement the work carried out in water with the water, "in practice", and enter all activities in water in a rehabilitation plan more large to be truly effective.
operational resources to achieve the therapist and design an effective rehabilitation intervention in the water are numerous: The progressive autonomy
flotation going from float to fixed points, keeping the patient the use of semi-mobile devices to float independently.
The water level may determine the variation of hydrostatic pressure and the buoyancy of the body. You can design and make it possible, for example, a progressive recovery of walking starting from the high floating without support and gradually reduce the depth thus increasing the load on the muscles of the lower limbs.
speed exercises. The water slows down or speed up the execution of the movements of the patient and stimulate in various ways and in his whole musculoskeletal system.
floating aids: bars, donuts, mats, etc.. etc.. Their volume and their arrangement on different sides of the patient's body allow us to emphasize the principles of hydrodynamics and its neurophysiological effects to optimize the therapeutic work. The use of bars, cakes, tubes or other aids can increase or decrease buoyancy and change the structure of the body in water according to need. For example, a patient can help to maintain a desired position by supporting a body part, or adding an external force, to face building activities. Similarly aids such as tablets by increasing the surface can be used to increase the resistance to movement in strength training or to slow it down, encouraging learning and the coordinated control by the patient. We can conclude that all the properties of water that play an important role for rehabilitation purposes, can be expanded using appropriate techniques and devices to enhance their therapeutic possibilities. The
taken of the patient. They are a fundamental part of the technique dell'idrokinesiterapista, because they are used both to assist and transport the patient safety in order to foster its postural changes in water prone to supine to standing up. Are crucial to providing security and active help to children, through the vents starts and establishes that relationship and the non-verbal communication is very strong that another important feature of motor activity in the water.
